The present invention relates to instrumentation used in implantation of an osteochondral graft, more particularly, to a delivery device used in inserting the osteochondral graft in a previously prepared hole. The invention also relates to the use of the delivery device to implant an osteochondral graft.
The delivery device of the present invention can also be used or adapted for use with bone-only or cartilage-only grafts or grafts of other construction, including artificial grafts, such as non-tissue grafts made from metals and synthetic materials. The invention has particular utility in repairing localized damage to bone and cartilage, such as lesions and other defects in an articular surface of the knee or other weight-articulating joints.
The knee and other articulating joints are susceptible to lesions and other defects. These may be the result of injuries caused by friction between opposing bone surfaces. While treatment options for these injuries lie along a continuum of care culminating in joint replacement, one treatment option is to replace the osteochondral tissue at the site of the injury with a graft of healthy tissue. Typically, autografts or allografts are employed; however, xenografts and artificial grafts, as previously described, may be employed. The surgery to implant these grafts often can be conducted arthroscopically. For this and other reasons, graft implantation may be more desirable than joint replacement.
The procedure for implanting osteochondral grafts involves creating a recipient site by removing the localized defect. Typically, this is done by forming a hole of a desired diameter (or holes, potentially, depending on the size of the defect) at the site of the damage. The hole may be bored, punched, or curetted, etc. The excised hole is then filled with a replacement osteochondral graft having a diameter corresponding to the diameter of the hole. The typical graft is cylindrical in shape and consists of a layer of cartilage over a layer of bone. Depending on the size of the damage, multiple holes of the same or different diameters may be bored and filled. Generally, in such instances, one hole will be bored and then filled before an adjacent or even overlapping hole is bored and filled.
Varied instrumentation is required throughout the surgery, both for forming the hole and implanting the replacement graft. Certain instrumentation may be tailored to the specific implant diameter.
Due to the delicate nature of the implantation procedure, in that its ultimate purpose is to repair or replace the articular surface and restore normal function to the joint, the method by which the transplanted osteochondral graft is handled and introduced into the recipient site is of particular importance. A desirable delivery device would provide a means for securely holding onto the osteochondral graft so that it is not displaced from the delivery device prematurely while simultaneously avoiding damage to the osteochondral graft.